The present invention relates generally to apparatus for pressure-pulse therapy. The present invention relates in particular to the generation of compound pressure pulses especially for orthopedic therapy.
Pressure-pulse therapy, also known as shock-wave therapy, has many uses. It is used in lithotripsy as a non-invasive technique for pulverizing kidney stones and calculi in the bladder and urethra. It is also used for dissolving lipids in cells close to the skin and in the pelvic region. In particular, it has many uses in orthopedic medicine, for example, as a therapeutic means for any of the following:
i. osteoporosis and the inducement of bone growth;
ii. joining of bone fracture, especially, ununion fractures, i.e., fractures that have failed to unite and heal;
iii. disintegration of calculi and (or) calcification in fibers, joints, and tendinitis; and
iv. pain relief in the cases of calcific tendinitis of the shoulder joint, tennis elbow, golf elbow, and plantar fasciitis (with and without heel spur).
U.S. Pat. No. 4,620,545 xe2x80x9cNon-Invasive Destruction of Kidney Stonesxe2x80x9d to Shene et al., whose disclosure is incorporated herein by reference, describes a pressure-pulse therapy apparatus which includes an ellipsoidal reflector, having a first focal point within the reflector""s dome and a second focal point outside the reflector""s dome. A flexible diaphragm caps the reflector, and the region contained by the reflector and the diaphragm is filled with a liquid medium, for pulse propagation. A pressure-pulse source is located at the first focal point, within the medium. This configuration provides that a portion of a pulse originating from the source, at the first focal point, will impinge on the reflector, be reflected by it, and be brought into focus at the second focal point. The reflector is movable and can be positioned so that the second focal point coincides with a concretion within the body that is to be pulverized. Sonic aiming means are used to detect the concretion and to direct the positioning of the reflector.
In general, pressure-pulse therapy is accompanied by an imaging means, such as the sonic aiming means of U.S. Pat. No. 4,620,545. The region for treatment is generally small, between 0.3 and 1.5 cm, and it is desirous to image the location in order for the therapy to be applied effectively. X-ray imaging may be used; however, with x-rays, the patient and the physician are exposed to radiation doses with each treatment.
PCT patent publication PCT WO 93/14720, xe2x80x9cMethod and Apparatus Particularly Useful for Treating Osteoporosis,xe2x80x9d to Spector, whose disclosure is incorporated herein by reference, offers an alternative to the need for an imaging means. It has a generally parabolic reflector, which has a single focal point within the reflector""s dome. A flexible diaphragm caps the reflector and the region contained by the reflector and the diaphragm is filled with a liquid medium, as in the previous patent. A pressure-pulse source is located at the focal point, within the liquid. This configuration provides that a portion of a pulse originating from the source, at the focal point, will impinge on the reflector, and be reflected by it, collimated. In other words, the reflected pulse will be a non-focusing wave, so focusing means are not essential. Pressure pulse therapy can thus be image free.
However, with a collimated beam, some pressure pulse energy is lost, when compared with a beam that is focused at the region for treatment. It would be desirable to direct more of the pressure-pulse energy at the region for treatment, without being dependent on an imaging means.
The present invention seeks to provide a therapeutic pressure pulse formed as a compound pressure pulse of at least two subordinate pulses.
There is thus provided, in accordance with the present invention, a dome-shaped reflector, having:
a center section, having predetermined first curvature and reflective characteristics associated therewith, and formed to reflect a primary pressure pulse propagating thereon, so as to form a first subordinate pressure pulse of a compound pressure pulse; and
at least one ring section, substantially concentric with said center section, having predetermined second curvature and reflective characteristics associated therewith, and formed to reflect the primary pressure pulse propagating thereon, so as to form at least one additional subordinate pressure pulse of said compound pressure pulse.
Additionally, in accordance with the present invention, said center section is substantially parabolic and has a single focal point.
Further in accordance with the present invention, said at least one ring section is substantially ellipsoid and has proximal and distal focal points with respect to said reflector, wherein said focal point of said center section and said proximal focal point of said at least one ring section substantially coincide.
Additionally, in accordance with the present invention, said at least one ring section includes a plurality of substantially ellipsoid ring sections, each having proximal and distal focal points with respect to said reflector, wherein said proximal focal points of said plurality of ring sections substantially coincide, wherein said distal focal points of said plurality of ring sections are adjacent to each other, and wherein said focal point of said center section and said proximal focal points of said plurality of ring sections substantially coincide.
Alternatively, said center section and said at least one ring section are substantially ellipsoid, each having proximal and distal focal points with respect to said reflector, wherein said proximal focal point of said center section and said proximal focal point of said at least one ring section substantially coincide.
Alternatively, said center section is generally parabolic and has a single focal zone.
Additionally, said at least one ring section is generally ellipsoid and has proximal and distal focal zones with respect to said reflector, wherein said focal zone of said center section and said proximal focal zone of said at least one ring section generally coincide.
Additionally, said at least one ring section includes a plurality of generally ellipsoid ring sections, each having proximal and distal focal zones with respect to said reflector, wherein said proximal focal zones of said plurality of ring sections generally coincide, wherein said distal focal zones of said plurality of ring sections are generally adjacent to each other, and wherein said focal zone of said center section and said proximal focal zones of said plurality of ring sections generally coincide.
Alternatively, said center section and said at least one ring section are generally ellipsoid, each having proximal and distal focal zones with respect to said reflector, wherein said proximal focal zone of said center section and said proximal focal zone of said at least one ring section generally coincide.
Alternatively, said predetermined curvatures and reflective characteristics are determined by numerical analysis.
Additionally, said predetermined curvatures and reflective characteristics include a predetermined zone at which both said first subordinate pressure pulse and said at least one additional subordinate pressure pulse are reflected.
Alternatively, said predetermined curvatures and reflective characteristics include:
a predetermined point at which said first subordinate pressure pulse is reflected; and
a predetermined point at which said at least one additional subordinate pressure pulse is reflected.
Alternatively, said predetermined curvatures and reflective characteristics include:
a predetermined zone at which said first subordinate pressure pulse is reflected; and
a predetermined zone at which said at least one additional subordinate pressure pulse is reflected.
Alternatively, said predetermined first curvature is selected from a group which consists of generally parabolic, substantially parabolic, generally ellipsoid, substantially ellipsoid, and a curvature which is determined by numerical analysis to yield said predetermined first reflective characteristics.
Additionally, said predetermined second curvature is selected from a group which consists of generally parabolic, substantially parabolic, generally ellipsoid, substantially ellipsoid, and a curvature which is determined by numerical analysis to yield said predetermined second reflective characteristics.
Further in accordance with the present invention, said predetermined curvature and reflective characteristics include a predetermined phase difference between said first subordinate pressure pulse and said at least one additional subordinate pressure pulse.
Additionally, in accordance with the present invention, said phase difference is between 0.5 and 1 microsecond.
Additionally, in accordance with the present invention, said at least one ring section, having predetermined second curvature and reflective characteristics associated therewith, includes a plurality of ring sections, each having predetermined curvature and reflective characteristics associated therewith, formed to reflect a primary pressure pulse propagating thereon, from said pressure-pulse source, so as to form a plurality of additional subordinate pressure pulses of the compound pulse, wherein said plurality of additional subordinate pressure pulses of the compound pulse include predetermined phase differences between them.
There is thus also provided, in accordance with the present invention, a dome-shaped reflector, having:
a center section, having predetermined first curvature and reflective characteristics associated therewith, and formed to reflect a primary pressure pulse propagating thereon, so as to form a first subordinate pressure pulse of a compound pressure pulse; and
at least one ring section, generally concentric with said center section, having predetermined second curvature and reflective characteristics associated therewith, and formed to reflect the primary pressure pulse propagating thereon, so as to form at least one additional subordinate pressure pulse of said compound pressure pulse.
There is thus also provided, in accordance with the present invention, pressure-pulse therapy apparatus, which includes:
a dome-shaped reflector, having:
a center section, having predetermined first curvature and reflective characteristics associated therewith, and formed to reflect a primary pressure pulse propagating thereon, so as to form a first subordinate pressure pulse of a compound pressure pulse; and
at least one ring section, substantially concentric with said center section, having predetermined second curvature and reflective characteristics associated therewith, and formed to reflect the primary pressure pulse propagating thereon, so as to form at least one additional subordinate pressure pulse of said compound pressure pulse;
an x-axis passing through its center;
an open end;
a flexible diaphragm, which caps said open end;
a fluid medium contained within said reflector and said diaphragm, for facilitating propagation of the pressure pulses;
a pressure-pulse source, immersed in said medium, located between said reflector and said diaphragm, on said x-axis, for generating the primary pressure pulse; and
a power supply, which supplies power to said pressure-pulse source.
Additionally, in accordance with the present invention, said first and second curvatures and reflective characteristics are associated with a point P, located on said x-axis, wherein said pressure-pulse source is located at said point P.
Alternatively, said first and second curvatures and reflective characteristics are associated with a point P, located on said x-axis, wherein said pressure-pulse source is located at a point Pxe2x80x3 on said x-axis.
Additionally, said point P is more proximal to said reflector than said point Pxe2x80x3.
Alternatively, said point P is more distal to said reflector than said point Pxe2x80x3.
Further in accordance with the present invention, said apparatus includes a linear extender for varying a distance between said pressure-pulse source and said reflector, along said x-axis.
Additionally, in accordance with the present invention, said pressure-pulse source is selected from a group which consists of substantially and generally point pressure-pulse sources.
Further in accordance with the present invention, said pressure-pulse source is a spark discharge source.
Alternatively, said pressure-pulse source is an electromagnetic pressure-pulse source.
Additionally, in accordance with the present invention, said pressure-pulse is operable to generate primary pressure pulses in the range between 1000 and 6000 bars.
Further in accordance with the present invention, said apparatus is operable to generate, from the primary pressure pulse, subordinate pressure pulses in the range between 5 and 600 bars.
Additionally, in accordance with the present invention, said apparatus is arranged for traveling along at least one axis, for positioning against a tissue surface of a body.
Further in accordance with the present invention, said apparatus is arranged for traveling along a plurality of axes, for positioning against a tissue surface of a body.
Additionally, in accordance with the present invention, said apparatus is arranged for tilting along at least one angular direction, for positioning against a tissue surface of a body.
Further in accordance with the present invention, said apparatus is arranged for tilting along a plurality of angular directions, for positioning against a tissue surface of a body.
Additionally, in accordance with the present invention, said apparatus includes a support fixture for a portion of a body to be treated.
There is thus also provided, in accordance with the present invention, pressure-pulse therapy apparatus, which includes:
a dome-shaped reflector, having:
a center section, having predetermined first curvature and reflective characteristics associated therewith, and formed to reflect a primary pressure pulse propagating thereon, so as to form a first subordinate pressure pulse of a compound pressure pulse; and
at least one ring section, generally concentric with said center section, having predetermined second curvature and reflective characteristics associated therewith, and formed to reflect the primary pressure pulse propagating thereon, so as to form at least one additional subordinate pressure pulse of said compound pressure pulse;
an x-axis passing through its center;
an open end;
a flexible diaphragm, which caps said open end;
a fluid medium contained within said reflector and said diaphragm, for facilitating propagation of the pressure pulses;
a pressure-pulse source, immersed in said medium, located between said reflector and said diaphragm, on said x-axis, for generating the primary pressure pulse; and
a power supply, which supplies power to said pressure-pulse source.
There is thus also provided, in accordance with the present invention, a pressure-pulse therapy method, which includes:
generating a primary pressure pulse;
propagating the primary pressure pulse in a fluid medium;
employing a reflector, having:
a center section, having first curvature and reflective characteristics associated therewith; and
at least one ring section, having second curvature and reflective characteristics associated therewith;
reflecting a first portion of the primary pressure pulse by the center section, thus forming a first subordinate pressure pulse of a compound pressure pulse; and
reflecting at least one additional portion of the primary pressure pulse by the at least one ring section, thus forming at least one additional subordinate pressure pulse of said compound pressure pulse.
Additionally, in accordance with the present invention, reflecting a first portion of the propagation includes reflecting the propagation in a substantially collimated manner.
Alternatively, reflecting a first portion of the propagation includes reflecting the propagation in a generally collimated manner.
Alternatively, reflecting a first portion of the propagation includes reflecting the propagation as a substantially focusing propagation.
Alternatively, reflecting a first portion of the propagation includes reflecting the propagation as a generally focusing propagation.
Additionally, in accordance with the present invention, reflecting at least one additional portion of the propagation includes reflecting the propagation as a substantially focusing propagation.
Alternatively, reflecting at least one additional portion of the propagation includes reflecting the propagation as a generally focusing propagation.
Additionally, in accordance with the present invention, said method includes reflecting the first portion of the primary pressure pulse propagation and reflecting at least one additional portion of the primary pressure pulse propagation with a phase difference between them.
Further in accordance with the present invention, employing a reflector includes employing a reflector formed of a plurality of sections that include:
a center section, having predetermined first curvature and reflective characteristics associated therewith; and
a plurality of ring sections, having predetermined curvatures and reflective characteristics associated therewith,
wherein reflecting at least one additional portion of the primary pressure pulse propagation includes reflecting a plurality of additional portions of the primary pressure pulse propagation by said plurality of sections, thus forming a plurality of additional subordinate pressure pulses.
Additionally, in accordance with the present invention, said method includes reflecting the plurality of additional portions of the primary pressure pulse propagation with phase differences between them.
Further in accordance with the present invention, said method includes varying a distance between the reflector and a pressure-pulse source.
Additionally, in accordance with the present invention, said method includes therapeutically applying the compound pressure pulse to a tissue of a body.
Further in accordance with the present invention, the tissue is human tissue.
There is thus also provided, in accordance with the present invention, a disk-like acoustic lens, having:
a center section, having predetermined first curvature and focusing characteristics associated therewith, and formed to direct a primary pressure pulse propagating thereon, so as to form a first subordinate pressure pulse of a compound pressure pulse; and
at least one ring section, substantially concentric with said center section, having predetermined second curvature and focusing characteristics associated therewith, and formed to direct the primary pressure pulse propagating thereon, so as to form at least one additional subordinate pressure pulse of said compound pressure pulse.
Additionally, in accordance with the present invention, said predetermined curvatures and focusing characteristics are determined by numerical analysis.
Further in accordance with the present invention, said predetermined curvatures and focusing characteristics include a predetermined zone at which both said first subordinate pressure pulse and said at least one additional subordinate pressure pulse are directed.
Alternatively, said predetermined curvatures and focusing characteristics include:
a predetermined point at which said first subordinate pressure pulse is directed; and
a predetermined point at which said at least one additional subordinate pressure pulse is directed.
Alternatively, said predetermined curvatures and focusing characteristics include:
a predetermined zone at which said first subordinate pressure pulse is directed; and
a predetermined zone at which said at least one additional subordinate pressure pulse is directed.
Alternatively, said predetermined curvatures and focusing characteristics include a predetermined phase difference between said first subordinate pressure pulse and said at least one additional subordinate pressure pulse.
Additionally, in accordance with the present invention, said phase difference is between 0.5 and 1 microsecond.
Further, in accordance with the present invention, said at least one ring section, having predetermined second curvature and focusing characteristics associated therewith, includes a plurality of ring sections, each having predetermined curvatures and focusing characteristics associated therewith, formed to reflect a primary pressure pulse propagating thereon, so as to form a plurality of additional subordinate pressure pulses of said compound pressure pulse.
Additionally, in accordance with the present invention, said plurality of additional subordinate pressure pulses of said compound pressure pulse include predetermined phase differences between them.
Additionally, in accordance with the present invention, said lens includes a cutout section that allows a portion of the primary pressure pulse to pass through it, undisturbed.
Additionally, in accordance with the present invention, said cutout section is said center section.
There is thus also provided, in accordance with the present invention, a disk-like acoustic lens, having:
a center section, having predetermined first curvature and focusing characteristics associated therewith, and formed to direct a primary pressure pulse propagating thereon, so as to form a first subordinate pressure pulse of a compound pressure pulse; and
at least one ring section, generally concentric with said center section, having predetermined second curvature and focusing characteristics associated therewith, and formed to direct the primary pressure pulse propagating thereon, so as to form at least one additional subordinate pressure pulse of said compound pressure pulse.
There is thus also provided, in accordance with the present invention, pressure-pulse therapy apparatus, which includes:
a disk-like acoustic lens, having:
a center section, having predetermined first curvature and focusing characteristics associated therewith, and formed to direct a primary pressure pulse propagating thereon, so as to form a first subordinate pressure pulse of a compound pressure pulse; and
at least one ring section, substantially concentric with said center section, having predetermined second curvature and focusing characteristics associated therewith, and formed to direct a primary pressure pulse propagating thereon, so as to form at least one additional subordinate pressure pulse of said compound pressure pulse;
proximal and distal sides with respect to a tissue for treatment;
an enclosure with an open end;
a flexible diaphragm, which caps said open end;
a fluid medium, contained within said enclosure, for facilitating propagation of the pressure pulses;
a pressure-pulse source, which includes a disk-like, electromagnetic pressure-pulse source, immersed in the medium, located at said distal side of said acoustic lens, for generating a collimated primary pressure pulse that propagates in said medium, and impinges on said acoustic lens; and
a power supply, which supplies power to said pressure-pulse source.
There is thus also provided, in accordance with the present invention, pressure-pulse therapy apparatus, which includes:
a disk-like acoustic lens, having:
a center section, having predetermined first curvature and focusing characteristics associated therewith, and formed to direct a primary pressure pulse propagating thereon, so as to form a first subordinate pressure pulse of a compound pressure pulse; and
at least one ring section, generally concentric with said center section, having predetermined second curvature and focusing characteristics associated therewith, and formed to direct a primary pressure pulse propagating thereon, so as to form at least one additional subordinate pressure pulse of said compound pressure pulse;
proximal and distal sides with respect to a tissue for treatment;
an enclosure with an open end;
a flexible diaphragm, which caps said open end;
a fluid medium, contained within said enclosure, for facilitating propagation of the pressure pulses;
a pressure-pulse source, which includes a disk-like, electromagnetic pressure-pulse source, immersed in the medium, located at said distal side of said acoustic lens, for generating a collimated primary pressure pulse that propagates in said medium, and impinges on said acoustic lens; and
a power supply, which supplies power to said pressure-pulse source.
There is thus also provided, in accordance with the present invention, a pressure-pulse therapy method, which includes:
generating a primary pressure pulse;
propagating the primary pressure pulse in a fluid medium;
employing a disk-like acoustic lens, formed of at least two sections, which include:
a center section, having predetermined first curvature and focusing characteristics associated therewith; and
at least one ring section, having predetermined second curvature and focusing characteristics associated therewith;
focusing a first portion of the primary pressure pulse by the center section, thus forming a first subordinate pressure pulse of a compound pressure pulse; and
focusing at least one additional portion of the primary pressure pulse by the at least one additional ring section, thus forming at least one additional subordinate pressure pulse of said compound pressure pulse.
Additionally, in accordance with the present invention, focusing a first portion of the propagation includes substantially focusing the propagation.
Alternatively, focusing a first portion of the propagation includes generally focusing the propagation.
Additionally, in accordance with the present invention, focusing at least one additional portion of the propagation includes substantially focusing the propagation.
Alternatively, focusing at least one additional portion of the propagation includes generally focusing the propagation.
Additionally, in accordance with the present invention, focusing the first portion of the primary pressure pulse propagation and focusing at least one additional portion of the primary pressure pulse propagation with a phase difference between them.
Further in accordance with the present invention, employing a lens formed of at least two sections includes employing a lens formed of a plurality of sections, having predetermined curvatures and focusing characteristics associated therewith, wherein focusing at least one additional portion of the primary pressure pulse propagation includes focusing a plurality of additional portions of the primary pressure pulse propagation by said plurality of sections, thus forming a plurality of additional subordinate pressure pulses.
Additionally, in accordance with the present invention, said plurality of additional subordinate pressure pulses include predetermined phase differences between them.